Category: Policy Updates

Graham to Testify at House Ways & Means Oversight Subcommittee January 24

NCPA Senior Fellow John R. Graham has been invited to testify in person to the U.S. House of Representatives Ways & Means Oversight Subcommittee on January 24 at 2 p.m. The topic is Obamacare’s individual mandate to buy health insurance, which Graham concludes is a burden without benefit.

Learn more at this link. Come in person, or watch online.

Puzder Pick a Second Win on Health Reform

puzderSoon after announcing his intention to nominate Tom Price, MD as U.S. Secretary of Health & Human Services, Donald Trump announced his intention to nominate Andrew Puzder Secretary of Labor. This is yet another good sign for the repeal of Obamacare.

Since the election, the media have asserted repealing Obamacare will yank health insurance from over 20 million people. This refers to Obamacare’s having increased welfare dependency (via expanding Medicaid) and the expensive individual policies offered in its exchanges, subsidized by tax credits.

This has sucked oxygen out of another important part of the debate, which is Obamacare’s regulations on employment. The Congressional Budget Office projects Obamacare will shrink the workforce by 2 million full-time equivalent (FTE) jobs in 2025.

The CEO of CKE Restaurants, which owns the Carl’s Junior and Hardee’s brands, Mr. Puzder warned of the harm to jobs in chain restaurants from Obamacare’s mandate to offer employees overpriced health insurance as far back as July 2013:

The Regulatory State Reaches The Wellness Industry

Women joggingThe Equal Employment Opportunity Commission (EEOC) has finalized rules on how employers can use wellness programs. By current federal standards, the rules are concise: 19 pages pertaining to the Americans with Disabilities Act and 17 pages pertaining to the Genetic Information Nondiscrimination Act. Both laws are extremely popular. The ADA (1990) passed by 91-6 in the U.S. Senate and 377-28 in the U.S. House of Representatives. The GINA (2008) passed by 95-0 in the Senate and 414-1 in the House.

These laws are meant to prevent discrimination. However this bumps against the real world where health insurers cannot charge different premiums to individuals who are sick. The Accordable Care Act (2010) allows employers to offer incentives to workers who participate in wellness programs, and can offer financial incentives up to 30 percent of premium (or up to 50 percent for anti-smoking programs). However, participation in a wellness program also necessitates surrendering personal health information to an employer who would otherwise be barred from having it (under the Health Insurance Portability and Accountability Act, 1996).

Because employers cannot use underwriting for medical risk to charge different premiums to different employees, it is hard to avoid the conclusion that wellness programs are less designed to make or keep employees well, as to ensure healthy people are attracted to the employer and sick people are not. Evidence suggests this is the real consequence of workplace wellness programs.

Fast Track to Nowhere? Biologic Intellectual Property in the Trans-Pacific Partnership

TPPThe Trans-Pacific Partnership (TPP) trade agreement is in deep trouble. It has taken nine years to finalize this extremely important multilateral deal among the United States and 11 other countries committed to overcoming domestic political obstacles to expand the benefits of free trade.

The final text was released publicly November 5, 2015, starting a legally required 90-day countdown before the president could sign it. This waiting period ended with the U.S. delegation joining representatives of the other countries in New Zealand on February 4 to ink the deal.

The deal had bipartisan (but not unanimous) support in Congress. Unfortunately, President Obama did not insist on adequate protection of intellectual property in biologic medicines, alienating Congressional allies and likely dooming the deal to failure, according to an analysis published today by NCPA.

Read the two-page Brief Analysis here.

The Benefits of Intellectual Property Protection

GIPCIf there is one thing about which libertarians are never likely to agree, it is whether intellectual property – patents, copyrights, trademarks, and trade secrets – should receive the same legal protection as physical property.

Without wading too deep into the philosophical debate, but showing my colors as an IP advocate, let me share some new research published by the U.S. Chamber of Commerce’s Global Intellectual Property Center (GIPC) illustrating the benefits of legal protection of intellectual property.

Published on February 10, Infinite Possibilities ranks 38 countries by 30 indicators of strength of IP protection. The indicators measure both law and enforcement: Countries which do not enforce IP rights, despite the letter lf the law, are marked down. Most of the indicators are straight forward: Longer patent, copyright, or trademark terms are better; strong enforcement mechanisms are better; and treaty obligations protecting intellectual property invented in other countries is better.

Will Congress Fix Its Electronic Health Records Fiasco?

electronic-medical-recordThere is some hope that Congress will fix – at least partially – the largely bungled Electronic Health Records (EHRs) deployment on which it spent $30 billion since 2009. Doctors are very frustrated by EHRS, which interfere with their practice of medicine. The current government program to have them installed nationwide should be abandoned.

Today, the Senate Health, Education, & Labor Committee marks up a number of bills to remove the regulatory burden in health care. One of them will address EHRs. Will it help? Maybe a little. First, it would force the federal government to reduce the administrative burdens associated with EHRs. Second, it would force the federal government to defer to the private sector on interoperability.

Ted Cruz and Health Reform

CruzSenator Ted Cruz has won the Iowa Republican caucuses. Over the weekend, Chris Wallace of Fox News challenged Mr. Cruz on his proposal “to sell health insurance across state lines,” citing research published by NCPA that concludes federal action to mandate this would be ineffective. The research in question is on this blog, here and here.

We got quite a bit of feedback yesterday on this topic. As a think tank, we endorse policies, not politicians. Nevertheless, some of our audience took Mr. Wallace’s question to reflect opposition to Senator Cruz.

In fact, Senator Cruz’ proposal to sell health insurance across state lines does not appear in his presidential campaign platform. It is in a Senate bill he proposed last March, in anticipation of the Supreme Court’s decision in King v. Burwell.

Private Sector Vigilance, Not Government Regulation, Protects Patients

18kqd35hi04oqjpgLast April, I cheered Arizona for passing a law allowing patients to order blood tests without a doctor’s prescription. The company that lobbied for the change, Theranos, was also interesting because it posted its prices at venues where patients could get blood drawn. It had a widely promoted partnership with Walgreens, which has a strategy of using new technologies to deliver more value-added services in the retail environment.

Since then, Theranos has gotten into trouble for being opaque about how it actually conducts its tests when the samples get back to its labs. This has led to turmoil in the business media and among investors which are interested in backing entrepreneurs with new approaches to lab testing.

Prostate Cancer Screening: Can the Government Get It Right?

Senior Man ThinkingProstate Specific Antigen (PSA) tests are back in the news, as they are one entry point for the government to start micromanaging how it pays doctors in Medicare. To set the stage:

  • Currently, Medicare pays for an annual PSA test for men 50 and older as “preventive care.”
  • However, Obamacare does not consider an annual PSA test for men 50 and over as “preventive care.”
  • The U.S. Preventive Services Task Force’s current guidelines (updated in 2012), recommend against PSA tests.
  • PSA testing has declined significantly since the 2012 guidelines were updated.
  • The American Cancer Society favors PSA tests for men over 50, and as early as 40 for men with more than one first-degree relative diagnosed with prostate cancer.

Ben Carson’s Health Proposal Look Good: But He Needs to Fill in the Details

Presidential candidate, Dr. Ben Carson, has provided a few more details about his health policy proposal. He backed away from calling for an end the Medicare and Medicaid programs. (Many Republicans fear talks about ending Medicare is a political non-starter among seniors.) Carson would apparently swap the open-ended tax exclusion Americans get from employer-sponsored health coverage for some type of tax credit.  Although not specified, the tax credit would likely come in the form of a deposit to a Health Savings Account (HSA).  There would presumably also be an element of personal responsibility where Americans set aside more for their health care needs. Putting workers themselves in control of these funds would cause them to conserve the funds more prudently than they do when employers pretend employee benefits are a free gift.